title: Analgesic effects of microwave ablation of bone and soft tissue tumors under local anesthesia.
abstract: OBJECTIVE
  To assess the feasibility and efficacy of microwave ablation (MWA) of painful refractory bone and soft tissue tumors performed under local anesthesia.
  
  
  METHODS
  A retrospective study between 2011 and 2013.
  
  
  METHODS
  A single center, Academic Interventional Pain Management Unit.
  
  
  METHODS
  Fifteen patients with 25 refractory painful bone (N = 19) or soft tissue (N = 6) tumors treated with MWA were consecutively included.
  
  
  METHODS
  Local Institutional Review Board approval was obtained, and written informed consent was waived. Lesions included spinal (N = 3), sacral (N = 4), and extraspinal (N = 18) locations. Pain was measured on a visual analog scale (VAS) from 0 to 10 before and immediately after procedure, at 1 week, and on a monthly basis following procedure. MWA procedures were always performed under computed tomography guidance and local anesthesia along with nitrous oxide inhalation.
  
  
  RESULTS
  Mean ablation time was 4.09 minutes (range 1-11) with an average of 4.2 cycles with a mean ablation power of 60 W. Preprocedure mean VAS score was 7.2 ± 0.97 (range 6-9). Follow-up postprocedure VAS scores were as follows: day 0: 1.64 ± 1.86, day 7: 1.82 ± 1.79, month 1: 2.05 ± 2.03 (14/15 patients), month 3: 2.13 ± 1.81, month 6: 2.36 ± 2.17; and were statistically significant (P < 0.001). Mean pain relief was 5.5 months.
  
  
  CONCLUSIONS
  MWA is feasible, safe, and effective in the management of painful refractory bone and soft tissue tumors. It may therefore be considered as a potential alternative to existing percutaneous ablation techniques in the management of bone and soft tissue tumors.
authors.affiliation: Neuroradiology Department, CLUNI, University Hospital, Grenoble, France; I4S Laboratory-EA 4268-IFR 133, Franche Comté University, Besançon, France.
authors.forename: Adrian
authors.initials: A
authors.lastname: Kastler
authors.forename: Hussein
authors.initials: H
authors.lastname: Alnassan
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Pereira
authors.forename: Guillaume
authors.initials: G
authors.lastname: Alemann
authors.forename: Daniel-Ange
authors.initials: DA
authors.lastname: Barbé
authors.forename: Sébastien
authors.initials: S
authors.lastname: Aubry
authors.forename: Florence
authors.initials: F
authors.lastname: Tiberghien
authors.forename: Bruno
authors.initials: B
authors.lastname: Kastler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001859:Bone Neoplasms / Q000150:complications / Q000532:radiotherapy*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000532:radiotherapy*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000532:radiotherapy*
keywords: Bone Tumors; CT Guidance; Local Anesthesia; Microwave Ablation; Soft Tissue Tumors